颈椎间盘突出症86例报告

Protrusion of Cervical Intervertebral Disc:A Report of 86 Cases

目的 :探讨颈椎间盘突出症的临床表现、诊断和治疗。方法 :对 86例颈椎间盘突出症患者 ,采用颈前路椎间盘摘除术 ,同时椎体间植骨融合术 5 4例 ,颈椎前路钢板 17例 ,椎间融合器和钢板 15例。结果 :86例均经随访 ,经术后 2年 6个月～ 12年 7个月随访 ,平均 4年 7个月。年龄 2 7～ 61岁 ,平均 44 7岁。症状消除 2 2例(2 5 5 % ) ,明显改善 3 8例 (4 4 2 % ) ,部分改善 2 6例 (3 0 6% ) ,优良率为 69 7%。结论 :颈椎间盘突出症不同于颈椎病 ,当有临床症状或轻微体征 ,或虽无临床体征而症状不见改善者 ,经保守治疗 3个月不见好转 ,宜行颈前路摘除突出颈椎间盘和植骨固定术。

Objective:To explore the clinical symptoms,diagnosis,treatment method and result of the protrusion of cervical intervertebral disc.Methods:From Jan. 1990 to Dec.2002,86 cases with the protrusion of cervical intervertebral disc(PCID)which were proved by CT scanning,coronal and sagital MRI films were treated with discectomy,intervertebral bone graft-fusion by anterior approach in 54 cases among the 86 cases,anterior plate-screws fixation in 17 cases,and used a cage and plate-screws in 15 cases.Results:All patients were followed-up from 26 months to 12 years and 7 months (averaged 4 years and 7 months).The age of patients were from 27 to 61 years old ( averaged 44.7 years old).The symptom eliminated completely (excellent) in 22 cases (25.5%),distinct improvement (good) in 38 cases (44.2%),and partial improvement in 26 cases (30.6%).The rate of excellent and good was 69.7%.Conclusion:The protrusion of cervical intervertebral disc is different from cervical spondylosis.Authors consider that the cervical intervertebral disc would be operated on with discectomy and intervertebral bone graft-fusion by anterior approach,when there were clinic symptoms or lightly signs only.